Why do I feel so depressed?

Depression is the most common mental illness with up to 10% of the UK population (at any one time) having this diagnosis according to the Mental Health Foundation. To be diagnosed with clinical depression, the symptoms need to be present for two continuous weeks (or less if more severe). However it’s also likely that whilst some people may not be ‘ill enough’ for a clinical diagnosis they are still feeling low.

So what is depression then?

As defined by the NHS, depression is ‘persistent sadness or low mood and/or marked loss of interests or pleasure, and a range of associated symptoms’. This is made up of negative thoughts such as “I can’t be bothered”, “I’m not good enough”, “I never get anything right”, “I’m useless”, “nobody likes me”, etc. Often confidence takes a knock, so tasks that were once done easily may now seem too much, difficulty making decisions or worried that the decisions will be wrong are common.

Added to this are behaviours usually linked with withdrawing from life such as not socialising, can’t face work, even tasks like housework can be ignored. Physically people can feel lethargic, aches and pains appear, headaches are common too. Appetite can change leading to eating too much (often comfort eating) or losing appetite and not feeling like eating. Sleep often is affected, either sleeping more often and napping in the day or maybe disturbed sleep at night leaving people feeling still very tired when they do wake up. So all of the signs and symptoms are pretty gloomy, the negative thoughts leading to a low feeling and reduced activity which in turn leads to confirming the negative thoughts which worsens the low mood and so on, deepening the negative spiral.

What causes depression?

Whilst it’s true that depression seems to run in some families, studies show that only about 10 percent of the population may be prone to a genetic disposition to depression.

The majority of depression comes as a reaction to life events such as redundancy, being unemployed for more than a couple of months, relationship problems, divorce, long-term illness, disability, bereavement, relocation, financial/work problems, trauma (either witnessing or experiencing), having a baby, being in a minority group (racial, religious, LGBTQ etc.), migrant, prisoner. In fact any situation where there is significant loss and/or change or where situations are out of someone’s control e.g. a panel of people making decisions regarding a person’s benefit level (the recent problems regarding the health assessments by ATOS caused significant problems).

Not only is it the negative situations themselves, but also individuals looking to the future and seeing little chance of change for the better and developing a sense of hopelessness.

So depression can be described as not having the resources to deal with a situation, resources such as emotional, motivational, financial or social support for instance and low mood developing leading on to varying degrees of depression.

It is worth pointing out that for some life events such as (but not restricted to) bereavement, divorce and job loss, it’s natural to go through a period of low mood/depression whilst mourning the loss/change but after a period of time the low mood should lift.

So for those where depression seems to run in the family, it’s more likely that depression develops as a learned behaviour. It may be that a young person may have seen a parent or close family member experience depression and that ‘normalises’ depression as an acceptable way of reacting to loss/change.

Sadly self-harm and suicide is often linked with depression. Usually self-harm as a way of initially trying to cope (as that may be the one thing that a person with depression has control over) and if there is no hope of positive change for the future then suicidal thoughts and attempts can take place.

How to overcome depression

There is no ‘one size fits all’ answer to this question. Factors affecting recovery are quite dependent on the resources the person with depression has. Resources such as any support from family, friends, what services/activities are available locally and also the nature of the event that may have been the cause of depression in the first place, has that changed, i.e. if the cause was a health change, is that for life or only a short while?

However, pretty much irrespective of the cause (and whether the cause is permanent or not) there are ways to lift low mood that can help most people.

Ideally, if people notice low mood for two continuous weeks, go to the GP - don’t wait as the sooner help is given the quicker the recovery. For mild to moderate low mood GPs will usually recommend talking therapy and / or possibly medication. What is prescribed by GPs seems to vary even within same surgeries but can also be influenced by the quality of the local talking therapy provider, some lengthy waiting times can lead to GPs thinking that they are only really left with prescribing medication. For moderate to severe depression then a combination of talking therapy (quite possibly with the local Community Mental Health Team (CMHT)) and medication is most likely.

The benefits of talking therapy are that they can help the person understand why and how they have reacted as they have done to the cause and then to develop strategies that can maintain well-being. Also part of talking therapy is to help to build resilience to cope better in case any future events happen that could trigger off low mood.

So initially, seeking professional help as soon as possible is key. But there are things we can all do to try and build in resilience that can protect against low mood. Talk. When situations happen that affect thoughts and moods, talking about this with family and/or friends can really help. Not only do you get chance to ‘get things off your chest’ but by sharing, other people may be able to put things in perspective or help overcome the situation and you are no longer carrying around the thoughts to yourself. It’s no surprise that women are good at sharing and offloading with social chatting, it really works. Whereas men find talking about ‘emotional’ issues awkward and often bottle them up with potentially harmful consequences.

Exercise is being recognised as one of the most effective ways to feeling good and either staying well or using exercise as part of recovery. Even getting out for 15-20 minutes a day has been proven to work well. In doing so there is the satisfaction that you are doing something other than just sitting indoors and there is the chance to look around and notice the world and possibly if done in a group, of meeting new people, which adds to feeling ‘good’.

For more information on keeping well, have a look at www.actionforhappiness.org where they have some simple, effective ideas.